------------------------------------------------------------------------------ The Tennessean - 1998 - Article with Citation ------------------------------------------------------------------------------ Headline: Plan aims to help elderly live at home Date: Nov. 20, 1998 Page: A1 Edition: Final Author: Duren Cheek Tennessean Staff Writer Text: State officials took the wraps off a plan yesterday to increase home and community- based care for the elderly and disabled in Tennessee but gave no hint of how much money Gov. Don Sundquist would commit to the program. If the recommendation of the Long-Term Care Services Advisory Council is approved, the state would come up with $10 million and the federal government would kick in another $20 million. Health Commissioner Nancy Menke said the plan, which must be approved by the federal Health Care Financing Administration, would provide services for about 13,000 people statewide under a $30 million funding scenario. "The governor hasn't committed to any specified number," Menke said. "He certainly is aware of the need and concern in this area. I am very pleased with the progress we have made. I think we are very close to making history." She said several people had approached her about the possibility of funding the program with some of the $4.8 billion Tennessee will receive from a settlement with tobacco companies. Under the agreement, the state would give up its right to sue for the cost of its treatment of tobacco-related illnesses. The state could receive $56 million-$58 million as early as next month if the deal goes through. "I know that all across Tennessee as well as the rest of the nation, everybody has their pencil and paper out trying to spend the dollars that have been discussed," she said. "I try not to be guilty of counting my chickens before they hatch." Sen. Douglas Henry of Nashville, a longtime advocate of more home- and community-based care for the frail and elderly, told Menke the plan is "the best single move" the state has made since replacing the bloated Medicaid program with TennCare. Fred Cloud, a Methodist minister and counselor, urged the council to adopt a plan that would allow the frail and elderly to remain at home as long as possible. "With all due respect to the nursing home industry, I do believe we could save money in Tennessee and make our citizens happier and provide adequate care if we provide a carefully constructed home health system." The plan would provide at-home services, including homemaker, personal care, and adult day health care for people who are nursing home eligible on a first-come, first-served basis. Homemaker services would include such things as sweeping, mopping, dusting, making the bed, washing dishes, personal laundry, ironing, mending and meal preparation. Personal care services would provide assistance with such activities as bathing, grooming, personal hygiene and dressing. The program would primarily serve women who are elderly, sick and poor, Menke said. Individuals enrolled in the program would have to be able to receive services in the home at a cost less than institutional care. The average cost of nursing home care is about $18,000 a year. The 14-member advisory council and the three member Long-Term Care Services Planning Council met yesterday to discuss the plan. They will add the final touches at its meeting next month. It will then be put into a waiver request, which will be forwarded to HCFA. Menke hopes to have the plan up and running by July 1. The planning and advisory councils were created earlier this year by the legislature. They are charged with coming up with a comprehensive plan to guide the future funding, coordination and delivery of long-term care services in Tennessee. The legislation passed after AARP and other groups seeking an alternative to nursing home care lost their battle to obtain some of the money that now goes to nursing homes, which have a powerful lobby in the legislature. ------------------------------------------------------------------------------